Individual
DONGWUK CHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 CHESTNUT STREET EXT, BRADFORD, PA 16701-5438
(814) 362-8478
Mailing address
600 CHESTNUT STREET EXT, BRADFORD, PA 16701-5438
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS038843
PA
Other
Enumeration date
07/18/2011
Last updated
07/18/2011
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